Two cases of multiple stab wounds: suicide or homicide?

Introduction. Multiple stab wounds in traumatic deaths usually indicate homicide. Nonetheless, a self-harming action should always be taken into consideration. Self-inflicted wounds tend to be in readily accessible regions of the body such as the anterior chest, neck and abdomen; sensitive areas are often spared. Hesitation wounds and no defence injuries are also typical of suicide. Materials and methods. Two cases of atypical suicide with a knife are reported. Homicide was initially suspected due to the amount and distribution of the injuries but, after investigation, the involvement of any other person could be excluded. Each case was subjected to a full medicolegal investigation with an autopsy and toxicological analyses. Background information was also reviewed. Results. Case 1: A 44-year-old male was found in an advanced stage of putrefaction on the floor of his flat. A lot of blood traces and a butterfly knife were found on the site. At autopsy, 14 stab wounds were identified to the anterior chest. Case 2: A 39-year-old male was found dead in his garage with a kitchen knife in his right hand. At autopsy, 25 stab wounds were identified to the neck and abdomen although only 14 were deeply penetrating. In both cases, there was a history of depression and there was no sign of forced entry or assault. Conclusions. The integration of circumstantial data, scene and autopsy findings, in particular with the study of the site, shape and direction of wounds are required to avoid misinterpretation of the manner of death.